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目的了解上海闵行区中心医院就诊丙型肝炎患者丙型肝炎病毒(hepatitis C virus,HCV)感染基因亚型分布情况,为今后制定丙型肝炎防治策略及针对性治疗提供依据。方法收集2012-2015年上海闵行区中心医院门诊及住院本地区丙型肝炎患者样本267例,所有样本HCV抗体阳性,巢式RT-PCR扩增HCV NS5B区,核酸阳性样本进行基因测序,运用邻近法(neighbor-joining)构建系统进化树,进行HCV基因亚型分析,比较不同基因亚型年龄分布和暴露因素的差异。结果病例均为上海本地区人,通过扩增获得132条HCV NS5B区序列,对132例样本进行基因分型,6a型56例(42.42%),3a型40例(30.30%),1b型26例(19.70%),2a型10例(7.58%),6a、3a型HCV感染者平均年龄低于1b型HCV感染者(P<0.01),不同基因亚型病毒性肝炎患者各暴露因素差异无统计学意义。结论上海局部地区丙型肝炎患者HCV亚型分布多样化,主要流行6a型和3a型。
Objective To investigate the distribution of genotypes of hepatitis C virus (HCV) infection in patients with hepatitis C in the Central Hospital of Minhang District, Shanghai for the purpose of providing evidences for the prevention and treatment of hepatitis C and the targeted treatment in the future. Methods A total of 267 hepatitis C patients from outpatient and inpatient department of Central Hospital of Minhang District in Shanghai from 2012 to 2015 were collected. All samples were positive for HCV antibody. HCV NS5B region was amplified by nested RT-PCR and nucleic acid positive samples were sequenced. (Neighbor-joining) to construct the phylogenetic tree to analyze the HCV genotypes, and to compare the age distribution and exposure factors of different gene subtypes. Results 132 cases of HCV NS5B region were obtained by amplification. The genotypes of 132 cases were genotyped in 56 cases (42.42%), 40 cases (30.30%) in type 3a and 26 cases in type 1b (19.70%), type 2a (7.58%), type 6a and type 3a HCV infection were lower than those of type 1b HCV infection (P <0.01). There was no significant difference in the exposure factors among different gene subtypes of viral hepatitis Statistical significance. Conclusion The distribution of HCV subtypes in hepatitis C patients in some areas of Shanghai is diversified. The main epidemic types are 6a and 3a.